Fear and chronic health problems: Part 1

Unconscious and automatic fear responses may be at the root of conditions like long covid and other chronic health issues associated with an over-active nervous system.

The cause of so many instances of chronic pain and chronic illness, like long covid or ME/CFS, seems to be an over active nervous system. The nervous system has been triggered into a fight/flight/freeze/fawn response, and now it’s gotten stuck in that triggered, over-activated state.

Because the nervous system is stuck in that state, many of our other bodily systems can’t function properly—our immune system can’t function properly, our digestive tract may not run smoothly, our sleep may be impacted, our nerves may misfire and send incorrect pain signals, etc. We end up with a huge range of symptoms and pain, as our bodies try to figure out how best to keep us safe.

A triggered nervous system is essentially a fear response. If you have a chronically triggered nervous system, that means that the root of these chronic conditions and all of these physical symptoms is fear.

The unconscious fear response

This might make perfect sense to you. But you might also be thinking something like, “Uh, do you know all the physical symptoms I’m dealing with right now? I’m not dealing with fear. These are real freaking health problems!”

If you’re in that second group, I get it and you’re right. If someone had told me this anytime during the first couple of years of long covid—or during any of the years leading up to it when I was working through other health conditions (food intolerances, chronic sinus infections, migraines, etc.)—not only would I have ignored them, I would have been pissed that they even suggested such a thing. Everything going wrong with me was really and very much wrong. But then I got desperate. I had already tried everything to get better, and all of my doctors were throwing their hands up in the air. I needed to open up to the idea that maybe what was wrong with me was something different.

To be clear, when I say our nervous systems are stuck in a fear state, this is not conscious fear. It happens at a completely unconscious level, and it remains repressed and hidden from our conscious minds because that’s how our brains and nervous systems work. Our brains are much more predictive than reactive. Our brains can’t process all of the information coming in from the world immediately, and so, when something happens to us that has happened before, our brains predict that our reaction needs to be the same. As a result, lots of different things are going wrong in our bodies because our brains are stuck in these patterns of responding unconsciously with fear.

As far as our brains being predictive, this is a good thing if, for example, someone cuts us off while driving or a child runs into the street. Our brains have learned that we likely need to hit the brakes and/or swerve, and the brain can quickly send signals through our body to take these necessary actions without us needing to consciously think through our options. However, if our brain learned an automatic response to keep us safe when we were seven, or if it got locked in a fear state during a global pandemic, it may still be deploying unnecessary reactions throughout our body without our conscious awareness that’s happening.

Fortunately, our brains are neuroplastic, which means these neural pathways can rewire themselves and we can develop new, automatic responses. However, for this to happen, we need to become consciously aware of our reactions and work through various techniques to change the unconscious response.

This is a really complicated process that I’m trying to write about in a couple short paragraphs, and I’m not a neuroscientist. So there’s a lot more going on here than I can write about, and it’s not yet clear to me if all of the mechanisms behind these unconscious responses, especially as they relate to chronic pain and illness, are even as well understood by science as we’d like them to be. But my reading and my personal experience have convinced me that chronic illness and chronic pain often occur because our nervous systems have gotten trapped in this fear response.

Considering two categories of fear

But how do you figure out what you’re scared of, and how does that affect the recovery process?

I believe there are essentially two sources of fear at the heart of an over-active nervous system: 1) fear of the symptoms and 2) fear of repressed thoughts and emotions.

I believe people who have these conditions fall into one of two categories: 1) they fear the symptoms, or 2) they fear repressed thoughts and emotions, as well as the symptoms.

I’ve written about this idea of two sources of fear before, but now I want to dive deeper into this idea, and I’ll do so with a series of posts over the next couple of weeks — and then I’ll keep coming back to this idea because that’s how ideas are reinforced for our unconscious minds.

A Quick Look at Category #1

From what I’ve seen and experienced, I suspect that if you’re in category #1, and you fear the symptoms, then your recovery is likely faster than the other group. I believe that the people in category #1 are likely the ones who were fully back to normal over a time span of weeks or months.

People in category #1 seem less likely to have had symptoms or issues prior to the start of whatever health condition they need to recover from. When the symptoms began for whatever condition they have, the fear and symptoms spiraled out of control. The people with this issue grew increasingly fearful of their symptoms, which made the fear worse, which then made their symptoms worse, and so on.

If this is you, then to address it, you have to directly face the fear of the symptoms. Typically, this involves doing the activities that trigger symptoms, and working through a series of techniques that involve retraining your brain to recognize that your body is safe and healthy and does not need these symptoms. I’ll dive into this in more detail later in this series, where I’ll talk more about the fear-symptom cycle in the nervous system and the various techniques to help break the cycle and return to a normal life.

I want to clarify that fearing the symptoms without the fear of the repressed emotions does not minimize how challenging these nervous system issues are to live with and to address. The pain and the illness and the symptoms are real, and in many cases, they are incredibly severe and debilitating, and then can last for years or longer if left unchecked.

A Quick Look at Category #2

I was one of the people in category #2. Those of us in category #2 also fear our symptoms and we have to do everything that the people in category #1 have to do to get better. However, not all of our symptoms are caused by the fear-symptom cycle. For us, the original source of fear is the thoughts and emotions that we believe are unacceptable and must be repressed. We likely learned these were unacceptable at a very young age, and so the repression of the thoughts and emotions is so automatic that most of us aren’t even aware that the thoughts and emotions ever existed. They’re buried deep in our unconscious.

This is important: The thoughts and emotions are buried, not gone. Whether we’re conscious of it or not, when we repress the thoughts and emotions, they don’t actually go anywhere. They stay inside of us, creating a constant source of stress and fear for our nervous system and our unconscious minds. Our nervous systems become over activated and stay that way for years and decades, and physical symptoms begin to appear or come and go over the years. Some of the symptoms seem to be a means of communication—our bodies are trying to get our attention to address the repressed issues—while other symptoms seem to be caused by our bodies not functioning as well because our nervous systems have been trapped in a chronic fight/flight/freeze state for so long.

Addressing the repressed issues that those of us in category #2 face is a bit more complex. As already mentioned, we have to do everything that the people in category #1 have to do to face the fear of symptoms and retrain our brains not to experience the symptoms or fear. But then those of us in category #2 also have to face our fear of the repressed thoughts and emotions, and this means doing all of the emotional work to uncover and process the thoughts and emotions that we’d previously repressed.

We have to rewire our brains and nervous systems to respond differently to various everyday stressors so that, moving forward, we continue to feel and express our emotions (in a healthy, non-aggressive way!), rather than repressing them. Some of this we can do on our own, and some of it may require the help of a therapist to move on from prior big-T and little-t traumas. This can take longer simply because there’s more for our nervous systems to process and rewire. I plan to dive into this more later in this series.

To be clear, this is my take on why some people recover using some techniques and why other people seem to require different techniques. I’ve come to these conclusions after 2+ years of reading a lot of books and journal articles, listening to a lot of interviews with people who recovered using mindbody techniques, talking with many people who either recovered or have made progress toward recovery, and working through my own experience with recovery.

If new information arises that causes me to question the two categories I’ve created, I will happily do so. But for now, I think understanding these two categories of fear is helpful for figuring out what we need to do to recover.